Individual
JORDAN OUELLETTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, RDN, LD
Contact information
Practice address
840 N 6TH ST STE 3A, COLUMBUS, OH 43215-1914
(330) 858-0488
Mailing address
840 N 6TH ST STE 3A, COLUMBUS, OH 43215-1914
(330) 858-0488
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
LD.09436
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
86168887
COMMISSION ON DIETETIC REGISTRATION
—
01
—
LD.09436
STATE MEDICAL BOARD OF OHIO
OH
Enumeration date
03/06/2022
Last updated
03/06/2022
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